"Coffee leads men to trifle away their time, scald their chops, and spend their money, all for a little base, black, thick, nasty, bitter, stinking nauseous puddle water." ~The Women's Petition Against Coffee, 1674

As a Psychologist, can I please point out that in this instance (as most rational beings would assume by default) FOX are incorrect, and the APA is correct.

Now I don't practice as a Psych, and have no interest in 'screwing people over for medication bills' - but caffeine IS, inarguably, a drug. By definition you CAN overdose, and there WILL be effects of withdrawal after prolonged exposure to it. At no point are the APA suggesting that people who drink coffee need help, just as they don't say that those who drink alcohol do. The DSM is designed to help psychiatrists and other health professionals give an accurate name to a problem - if someone presents with Caffeine withdrawal then it's helpful to have an actual definition for it. And, preferably, methods of treatment. I imagine, because of how short-term caffeine's effects are, the most that would be prescribed to an overdose is going to be to go cold turkey and drink a lot of water. Perhaps some dioralyte?

There are many misleading statements in the article (what else were we to expect from FOX?!) such as;

"What else could we expect, though, from an organization that also just created a disorder called binge eating disorder" - "Created"?! Yeah, they just 'made up', right now. It's not like it was covered by DSM-IV-TR's Bulimia Nervosa!

"Caffeine is a common dietary ingredient" - we use it ergo it must be fine?!

"I have met with thousands of daily caffeine users, and it has been a significant problem in the lives of precisely none of them." - Firstly any decent psychiatrist knows not to generalize case studies. Secondly, the DSM isn't about how significant a problem is, it is to do with understanding people. I love coffee, but I know full well it affects my cognition - sometimes for better, sometimes for worse.

As a side note, in case you weren't aware, Keith Ablow (the author of the article) resigned from the American Psychiatric Association, and has ever since attempted to discredit them - I mention this by way of an explanation for the emotional and colourful language he uses when talking about them...

As soon as you sit down to a cup of hot coffee, your boss will ask you to do something which will last until the coffee is cold.

The psychologist in me was going to keep quiet, but I guess now the cats out of the bag. :)

Caffeine intoxication was also included in the DSM-IV TR, and just moved into the main text in the DSM 5.

Although there are lots of reasons to be skeptical about the process the psychiatric association used in developing the DSM 5, I think it's still a useful diagnostic tool for mental health. There still is not enough reliance on scientific data and research, but with every edition it has generally gotten better. The DSM may even be in decline, since Medicare and Medicaid will be switching to the ICD-10. Don't get me started on the removal of the bereavement exception from Major Depressive Disorder.

In the case of Caffeine intoxication and withdrawal, I believe the importance of these diagnoses rests on two uses:

The increasing marketing and use of "energy" drinks by children and adolescents. These drinks are not like having a cup of coffee, for a couple reasons. They have a great deal more caffeine by volume than coffee. So the issue is not daily coffee drinkers, but rather people pounding down fruity beverages loaded with caffeine.

The differential diagnosis of caffeine effects versus anxiety disorders and schizophrenia. Excessive use of stimulants can induce a transient form of psychosis.

The writer of that article is in the business of creating arousal. Using his rhetorical style and tone, he gets people riled up. Aroused people are good for news businesses. Keeps 'em coming back, and the news organization can sell those people to the advertisers. Take all such rhetoric with a liberal dose of salt.

The psychologist in me was going to keep quiet, but I guess now the cats out of the bag. :)

Caffeine intoxication was also included in the DSM-IV TR, and just moved into the main text in the DSM 5.

Although there are lots of reasons to be skeptical about the process the psychiatric association used in developing the DSM 5, I think it's still a useful diagnostic tool for mental health. There still is not enough reliance on scientific data and research, but with every edition it has generally gotten better. The DSM may even be in decline, since Medicare and Medicaid will be switching to the ICD-10. Don't get me started on the removal of the bereavement exception from Major Depressive Disorder.

Is there significance of issues recognized by the DMS-5 (or ICD-10) and Obamacare coverage?

Just wondering if I could find a way for the Government to pay for my beans.

Len

"Coffee leads men to trifle away their time, scald their chops, and spend their money, all for a little base, black, thick, nasty, bitter, stinking nauseous puddle water." ~The Women's Petition Against Coffee, 1674

If you drink high quantaties of coffee over a period of 6 to 15 days, you might develop a tolerance towards caffeine. This is because caffeine interacts with the adenosine receptors in your body, which are located in the cell membrane and up-regulated, when stimulated continuously, i.e. the cell produces more receptors than usual, so that it requires a higher dose of stimulants to activate them.

There can be a physical and psychological addiction. Stop drinking coffee in a situation like that might lead to withdrawal symptoms like headache, drowsiness, depression, lack of concentration, discontentment, lack of energy or slight nausea, which are usually only short-lived. The signs usually start about 12 to 24 hours after last consumption, are most severe for one or two days and pass completely after two to nine days. Since coffee is a legal drug and freely available, that's not really a problem. There's no danger to your health, when consumed responsibly, which does include even five cups per day. The notion that coffee is bad for your health has been outdated for quite a while, but it's a folklore that still lingers in lot's of people's heads, even some physicians.

An overdose of caffeine (more than 1 g taken at once, which equals at least five cups of drip coffee or five double shots of espresso or 10 liters of cola or about 12 cans of energy drinks) can lead to signs of excitement like tachycardia and extrasystoles, raised blood pressure, sleeplessness, agitation, headache, and diarrhea, depending on the dose. A severe intoxication might even cause a syncope. For an otherwise healthy human being, the lethal dose for caffeine is about 10 g, again taken at once.

IMHO the difference between caffeine and other drugs is that it's legal, freely available, cheap, and unlike other legal drugs like alcohol or nicotine its regular use doesn't cause any major health problems. Consumed responsibly, which even includes drinking five cups per day, coffee won't ever cause any overdosing. The DSM-5 on the other hand makes caffeine dependency a psychiatric disorder, a disease, therefore creating a need for therapy. There's money to be earned here. Next thing might be that there'll be a health warning on your espresso cup.

***"This drink of the Satan is so delicious that it would be a shame to leave it to the infidels." (Pope Clement VIII on coffee, when he was urged to ban the beverage)

Overdosing on caffeine will kill you. To consume enough caffeine to kill you, drinking only espresso, will take somewhere in the realm of 150 - 200 shots of espresso. So yeah, drinking coffee is not going to kill you - you'd die of something else first no doubt...However. Monster Energy Drinks were caught up in a legal battle after a 14 year old died - he coroner’s report described “caffeine toxicity” as contributing to her death. There are real health issues related to caffeine consumption.

The DSM-5 on the other hand makes caffeine dependency a psychiatric disorder

And correctly so! Dependency on a drug is a bad thing! How is it not? If someone comes to you, and says "I can't do a thing during the day unless I have several strong coffees at regular intervals. I am LITERALLY dependent on it." Are you really telling me that the answer is "It's fine, it won't kill you, just keep drinking it."?

And on a final note. Please avoid referring to ANY mental illness as a disease.

As soon as you sit down to a cup of hot coffee, your boss will ask you to do something which will last until the coffee is cold.

Overdosing on caffeine will kill you. To consume enough caffeine to kill you, drinking only espresso, will take somewhere in the realm of 150 - 200 shots of espresso. So yeah, drinking coffee is not going to kill you - you'd die of something else first no doubt...However. Monster Energy Drinks were caught up in a legal battle after a 14 year old died - he coroner’s report described “caffeine toxicity” as contributing to her death. There are real health issues related to caffeine consumption.

Yes, it might. But like I said, it takes 10 g of caffeine in a single dose to kill an otherwise healthy human being. That's hard to swallow in the form of any drink. I think the energy drink with the highest caffeine concentration available in the U.S. contains 242 mg per serving. That's quiet a lot (most energy drinks contain significantly less). However, drinking large amounts of such a beverage over a very short period of time might lead to signs of overdosing. Everything is poisonous, it all depends on the dose.

AntWilliams90 Said:

And correctly so! Dependency on a drug is a bad thing! How is it not? If someone comes to you, and says "I can't do a thing during the day unless I have several strong coffees at regular intervals. I am LITERALLY dependent on it." Are you really telling me that the answer is "It's fine, it won't kill you, just keep drinking it."?

Whether or not this habit is a problem depends on the psychological strain it causes. Someone who seeks his or her doctor's advise for it is troubled. A lot of people find it hard to start the day without coffee, but don't make an issue of it. Why shouldn't they keep drinking it? The positive health effects of coffee by far outnumber the risks.

AntWilliams90 Said:

And on a final note. Please avoid referring to ANY mental illness as a disease.

Sorry, not being a native speaker I guess these (politically correct?!?) subtleties of the English language sometimes escape me. What's the difference between an illness and a disease? Aren't those words synonymous?

***"This drink of the Satan is so delicious that it would be a shame to leave it to the infidels." (Pope Clement VIII on coffee, when he was urged to ban the beverage)

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